Communication Tips for the Tracheotomy or Ventilator Patient

Imagine waking up one day and not being able to speak.  Feelings of anxiety, frustration, and fear would surely arise.  This is how a tracheotomy or ventilator patient feels. In order to make your Tracheotomy or Ventilator patient feel as comfortable as possible, it is vital to understand the importance of communication.

First, let’s discuss the differences between a tracheotomy (or trach for short) and ventilation.  By definition, a trach is a surgical procedure that is used in order to facilitate breathing via an opening in the throat.  This opening leads into the trachea, or windpipe, which allows oxygen to get into the lungs.  It allows for the option of using a ventilator, as needed.FoxSubacute_Communication with trach or Ventilator Patient

In contrast, a ventilator is a machine which supports breathing.  This machine, unlike the trach, breathes for the patient.  This is used primarily for patients who are unable to breathe on their own.

Trach and ventilator patients may be unable to verbally communicate without special adapters. It’s very possible for patients to regain the ability to speak after a tracheotomy, however they may not be able to speak in the same manner as they did before.  This is due to the fact that air flows differently and no longer passes the vocal cords.  In ventilator patients, tubes flow down the throat in order to support the patient’s breathing.  Since tubes are blocking the entire throat, no air is able to get through to produce sound.  Both of these situations will leave the patient without speech for a time.

Note: this information is specifically for those who are unable to utilize a special adapter (passy muir valve) to allow air to be forced through the vocal cords.  Each trach and ventilator patient is different.  Consult with their healthcare provider to learn more about their specific needs.

Here are a few tips to help you communicate with a trach and/or ventilator patient: FoxSubacute_FunEvents_Ventilator Patient

  1. Never assume that the patient cannot hear or understand you:  Although the trach and ventilator patient cannot verbally speak, he or she may still hear you.  Be aware of your conversations, whether as a family member or a healthcare provider. What if you couldn’t respond to a conversation? How would that make you feel?
  2. Explain what is going on: For those with a new trach, approach the trach or ventilator patient slowly and at eye level, as you do this, gently say “you have a device in your throat to help you breathe and you cannot speak when this is in place”.  This will lessen the patient’s confusion and anxiety. For those who have been a long-term trach or ventilator patient, communicate with them as you would with anyone else. Take their mental capacity and level of understanding into account, and proceed accordingly.
  3. Comfort the patient: This will put the patient more at ease with his or her surroundings.  In addition, your body language means everything.  Never intimidate the patient by moving too quickly or looking down at them.  Maintain eye contact and reassure him or her.
  4. Allow the patient to respond: The only way to completely relieve the patient’s stress is to allow him or her to respond to you.  This may take some time, so have some patience.  The first thing that you can do is ask them to write their concerns on paper.  This will work for trach and ventilator patients whose bodies are completely functional.  If you come across a paralyzed patient, they can often answer yes or no questions by nodding and shaking their heads or sometimes even by blinking their eyes.  Simply give them instructions for responding yes or no and then ask the question.  Make sure that you ask multiple questions regardless of whether or not they respond.  Sometimes patients have a limited mental capacity due to their illness or sudden change in lifestyle and need you to repeat the question in order to make sense of it.
  5. Know which questions to ask: Ask about the patient’s comfort.  Questions like, “are you comfortable?” or “does it hurt to breathe?”  Once the patient responds, you may have to respond appropriately and do whatever it takes to make the patient comfortable.  Make sure that you ask as many questions as possible.  For the patients that can only answer yes or no questions, it is possible that the patient is uncomfortable in another way that you did not ask about.

The most important thing to remember is that everyone wants to be treated with understanding and respect. Communicating with a trach and ventilator patient will make them more comfortable and will greatly improve their happiness.

If you are interested in learning more about Fox Subacute, or would like to tour one of our facilities, please contact us.